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Reagarding the following paragraphs given in your guidance for good medical practice

26. You must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence and the availability of other options for care

38. Patient safety may be affected if there is not enough medical cover. So you must take up any post you have formally accepted, and work your contractual notice period before leaving a job, unless the employer has reasonable time to make other arrangements.

These paragraphs are designed to guide behavious. But can you please advise more specifically how you define

"Emergency" - how short notice of an upcoming rota gap is deemed an emergency? Hours, days or weeks?

"reasonable time" - the time between the employee being notified of their upcoming employing trust can be as short as 5 weeks. How long before the start date would you deem a 'reasonable time' for trusts to make other arrangements. According to your guidance do those 'arrangements' have to be for the same cost as hiring the original employee?

"own safety" - according to your internal guidance, how many hours of working without break would be considered unsafe for the employee?

Lastly can you please advise how many referrals have been made to the GMC in the last 5 years citing failure of a doctor to fill an unfilled shift (that was not their own).
If that information is not available then please advise how many cases have been investigated solely upon the reported failure to follow guidance section 38. (see above)

We’ll get back to you as soon as we can with a further acknowledgement.
You’ll usually hear from us on the next working day, but it might take a
little longer during busy periods.

In the meantime, if you want any further information about the GMC, please
visit our website.

Thank you

Information access team

General Medical Council

Email: [GMC request email]

Telephone: 0161 923 6365

Working with doctors Working for patients

The General Medical Council helps to protect patients and improve medical
education and practice in the UK by setting standards for students and
doctors. We support them in achieving (and exceeding) those standards, and
take action when they are not met.

We’ll get back to you as soon as we can with a further acknowledgement.
You’ll usually hear from us on the next working day, but it might take a
little longer during busy periods.

In the meantime, if you want any further information about the GMC, please
visit our website.

Thank you

Information access team

General Medical Council

Email: [GMC request email]

Telephone: 0161 923 6365

Working with doctors Working for patients

The General Medical Council helps to protect patients and improve medical
education and practice in the UK by setting standards for students and
doctors. We support them in achieving (and exceeding) those standards, and
take action when they are not met.

2 Attachments

Thank you for your emails of 8 April 2016 and 2 May 2016. I’ve considered
your request under the Freedom of Information Act 2000 (FOIA).

May I please address each aspect of your request individually :-

1. “how many referrals have been made to the GMC in the last 5 years
citing failure of a doctor to fill an unfilled shift (that was not their
own).”

We input allegations behind complaints and referrals on our central system
once the substantive investigations have been concluded. For this reason,
we cannot provide the figure you require because of the amount of data and
the work that would be involved. Under the FOIA there’s an exemption for
requests where it would cost the public authority more than £450 to
process - equivalent to two and half day’s work. We would need to manually
check through each complaint received to confirm if it’s within the scope
of your request.

We received in excess of 30,000 complaints in the last 5 years and it
would take around 20 minutes to check through each record. Based on an
hourly rate of £25 per hour (which is set by the Freedom of Information
(Fees and Appropriate Limit) Regulations 2004) this would cost us
significantly in excess of the ‘appropriate limit’ to process.

Under the FOIA, the specific exemption which we believe applies is at
section 12. This states that we are not required comply with a request if
we estimate that the cost of doing so would exceed the ‘appropriate
limit’.

2. “If that information [at 1 above] is not available then please advise
how many cases have been investigated solely upon the reported failure to
follow guidance [paragraph] 38 [of the Good Medical Practice].”

Before turning to a substantive response, may I please explain how we
processed your request and relevant background information.

The current version of the Good Medical Practise (GMP) came into force on
22 April 2013. The previous version of the GMP, which in effect between 13
November 2006 and 21 April 2013, issues a similar guidance at paragraph 49
:-

“49 Patient care may be compromised if there is not sufficient medical
cover. Therefore, you must take up any post, including a locum post, you
have formally accepted, and you must work your contractual notice period,
unless the employer has reasonable time to make other arrangements.”

Secondly, I wish to explain that a single incident can often result in
multiple breaches of the GMP. For example, paragraph 34 states “When you
are on duty you must be readily accessible to patients and colleagues
seeking information, advice or support.” ; so if a doctor cannot be
contacted while on duty and s/he then leaves the post early, this could
potentially be a breach of both paragraphs 34 and 38.

Accordingly, we are unable to provide a figure as to cases where the
breach of paragraph 38 was the “sole reason” behind our investigation
without it being misleading. We have searched for allegations of (a)
leaving post early with or without notice and (b) failing to take up post.
The details are set out in the spreadsheet above. Please note that the
doctors may have also had other allegations made against them also.

3. Request for advice

You have also asked for advice concerning the following phrases set out in
the GMP: “emergencies” and “own safety” (both Paragraph 26) and
“reasonable time” (paragraph 38). Please note that the FOIA covers
requests for recorded information that is held by a public authority. This
aspect of your request is not within the remit of our FOIA response.

I have therefore asked my colleagues at the Education and Standards
Directorate to provide a response to you in this respect. I have attached
their advice letter for your kind perusal.

Your right to appeal

I'm sorry I couldn’t provide all the information you requested. You can
appeal against this decision to Julian Graves, Information Access Manager.
If you want to appeal, please set out your reasons and write to him at
the above address or email [1][email address]. You can also appeal to
the Information Commissioner, the regulator of the FOIA and DPA – we can
provide more details about this if you need them.